Turkish J Pediatr
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Traumatic chylothorax other than iatrogenic thoracic duct injury is extremely rare in children. Chylothorax can cause cardiopulmonary abnormalities and significant nutritional, metabolic and immunologic consequences. ⋯ The patient was successfully treated through a conservative approach with total parenteral nutrition, nothing by mouth, and bilateral chest tube drainage. The nature of pleural effusion developed following a blunt thoracic trauma is important in the management of trauma patients.
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Central venous catheter (CVC) fracture with embolization is a serious and rare complication, and few cases have been reported in children. Catheter fragments may cause cardiac perforation, arrythmias, pulmonary embolism, and sepsis. We report the successful retrieval of intracardiac CVC fragments by percutaneous transcatheter technique in two infants, aged 8 and 15 months. ⋯ The procedure was performed under ketamine anesthesia and fluoroscopic guidance using a percutaneous femoral vein approach. Nitinol Amplatz Goose Neck snares (10 mm in diameter) were used to successfully retrieve the catheter fragments without any complication. Percutaneous transcatheter retrieval of catheter fragments using Goose Neck snare is a safe and successful technique and can be chosen before resorting to surgery, which has potential risks related to general anesthesia, thoracotomy and cardiopulmonary bypass.
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We investigated characteristics of burns in children aged up to seven years and hospitalized at our Burn Unit between 1 January 2000 and 31 December 2007 in order to detect risk factors and prepare a program for prevention of burn injuries in children. There were 119 boys and 81 girls (ratio 1:0.67) and the mean total body surface area burned was 16.6 +/- 12.5%. Sixty-nine percent (n = 138) of the burn-injured children were under three years old. ⋯ The children included in this study were younger than seven years and they were supposed to be under the care of their parents. Parental neglect might have played a role in burn injuries in these children. In developing countries like Turkey, parents should be offered education about prevention of burn injuries in childhood.
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Although each method has its own advantages and disadvantages compared with the conservative mercury-in-glass thermometers, there are conflicting opinions about the optimal anatomic site for measuring body temperature as well about the variations in measurements with different methods. In this study, we aimed to assess the accuracy and reliability of measurements obtained from the axilla with the chemical thermometer (Tempa DOT TM) compared with the classic mercury-in-glass instruments. Sixty randomly selected pediatric patients who were admitted to our hospital were enrolled. ⋯ Since approximately 20% of febrile patients with mercury-in-glass temperature were misdiagnosed as afebrile with measurements via chemical thermometer, we suggest that the axilla is not a suitable anatomic site for screening of fever with Tempa. DOT. Further studies involving larger study groups with similar age should be done to more definitely assess its screening value in pediatrics.
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The aim of our study was to assess the attitudes and practices of doctors and nurses about end-of-life decisions and compare our results with those observed in different European countries. The data was collected from nurses and doctors, using a standardized questionnaire adapted from the EURONIC study. A total of 250 structured questionnaires were delivered, and 135 (77%) of them were accepted for analysis. ⋯ Seventy-five percent of the contributors agreed that everything possible should be done to ensure a neonate's survival regardless of the prognosis and 65.2% of responders believed that costs of health care should not affect nontreatment decisions. Most of the responders (65.2%) agreed that severe mental disability as an outcome was equal to or worse than death. In patients in whom medical intervention would be futile, or would not offer sufficient benefit to justify the burdens imposed, hospitals should set up a functional ethical committee in order to decide in matters of withholding or withdrawing intervention.